Lyme Disease in a Young Girl

Area of Science:

• Pediatric Orthopedics
• Infectious Diseases
• Sports Medicine

Background:

• Persistent bilateral knee pain and swelling in a pediatric patient can present diagnostic challenges.
• Standard orthopedic imaging (X-rays, bone scan) may not reveal the underlying cause of pediatric joint pain.
• Previous treatments like rest and physical therapy were ineffective, necessitating further investigation.

Purpose of the Study:

• To investigate the diagnostic utility of Lyme disease testing in pediatric patients presenting with chronic, undiagnosed knee pain.
• To highlight Lyme disease as a potential differential diagnosis in pediatric musculoskeletal complaints.

Main Methods:

• Case report of an 11 1/2-year-old female with a seven-month history of bilateral knee pain and swelling.
• Review of initial diagnostic workup including X-rays and bone scan, which were normal.
• Laboratory testing for Lyme disease was performed.
• Treatment with oral tetracycline was initiated.

Main Results:

• Laboratory studies confirmed a positive titer for Lyme disease.
• The patient experienced an uneventful recovery following antibiotic treatment.
• Resolution of knee pain and swelling was achieved.

Conclusions:

• Lyme disease should be considered in the differential diagnosis of pediatric patients with chronic knee pain and swelling, particularly when initial investigations are inconclusive.
• Prompt diagnosis and appropriate antibiotic therapy are crucial for successful management and recovery in pediatric Lyme disease presenting with joint manifestations.